Long-time observations on the Blalock-Taussig operation VIII. 20 to 28 year follow-up on patients with a tetralogy of Fallot.

This study extends our previous observation on patients with a tetralogy of Fallot, operated on by the late Dr; Alfred Blalock and his associates between 1945 and 1951, from a 15 year follow-up to 20 years and assesses the final status of these patients 20 to 28 years after their first operation. This study is mainly concerned with the 432 patients known to be alive at the beginning of the 15th postoperative year. At the beginning of the 20th year, 376 patients were alive, 24 had died, 32 had been lost to follow-up. Review of the final status of those 432 patients showed that 169 had no further cardiac surgery after their initial operation, 36 had further palliative surgery, and 227 had total correction. Thirty-seven percent of the first group, and 79.3% of those with total correction were doing well. These two groups, however, are not comparable. Approximately 250 patients have married; 161 have one or more children. Thirty-five percent have graduated from college and 68.7% are earning substantial incomes. The high scholastic achievement of many of these patients is strong evidence that low oxygen saturation of arterial blood is not a prime cause of mental retardation. The occupations of the patients indicate that the quality of their lives is extremely good and that a cardiac handicap in childhood does not preclude success in adult life. Approximately 69% of these patients have repaid in taxes the cost to society of their rehabilitation.